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Cindy Ung, Ines Lains, Russell L Woods, Anne Marie Lane, Deeba Husain, Joan W Miller, Evangelos S Gragoudas, Ivana K Kim, John B Miller; Evaluation of Choroidal Nevi with Swept-Source Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1882.
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© ARVO (1962-2015); The Authors (2016-present)
To explore the ability of swept-source optical coherence tomography (SS-OCT) to properly image choroidal nevi and to identify the morphologic characteristics associated with optimal visualization.
Prospective, cross-sectional study, including patients with choroidal lesions < 3 mm in thickness on ultrasound. All participants underwent color fundus photography (CFP), ultrasonography, and SS-OCT. For SS-OCT, we obtained a 3D horizontal volume (12 mm x 9 mm) and a radial protocol (12 lines) over the choroidal lesions. All images were evaluated by two independent graders. CFP were used to assess the degree of pigmentation of nevi. On SS-OCT we evaluated both qualitative (e.g. tumor outline, reflectivity and/or shadowing of choroidal layers, detection of scleral-choroidal interface, and quality of the image) and quantitative parameters (measurement of maximum lesion thickness and the largest basal diameter) defined a priori. The main outcome measure was the quality of the choroidal nevi images on SS-OCT, defined as optimal (all margins of the tumor well visible), suboptimal (at least one margin not properly imaged) or poor (more than one margin not properly imaged). Probability of optimal image quality was examined using ordered logistic regression.
We included 92 eyes of 89 patients with choroidal lesions <3mm in thickness on ultrasound. The mean patient age was 65 ± 12 years, and 56% were female. There were 24 choroidal lesions (26%) for which image quality was classified as optimal, 31 lesions (34%) as suboptimal and 30 lesions (33%) as poor. Seven lesions (8%) could not be visualized with SS-OCT. The factors independently associated with optimal image quality were closer distance from fovea (ß= -0.246, p=0.001), less ultrasound thickness (ß= -1.163, p=0.025), and lighter lesion pigmentation (p<0.021).
SS-OCT is useful in imaging most choroidal nevi. We were able to identify characteristics of choroidal lesions that affects optimal image quality with SS-OCT. Our results revealed that image quality decreases with increasing distance of the edge of the choroidal lesion from the fovea, increasing lesion thickness as measured with ultrasound and darker lesion pigmentation.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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